Effect of ipragliflozin on metabolic syndrome components and non-alcoholic fatty liver disease

Abstract

Sodium-glucose cotransporter-2 inhibitors are the new drugs for the treatment of type 2 diabetes mellitus. Its mechanism of action is to increase the excretion of glucose in the urine due to inhibition of reabsorption in the proximal renal tubules, which leads to a decrease in blood glucose levels. These drugs also have pleiotropic effects including reduce body weight and blood pressure, improve the lipid profile (raising high-density lipoprotein cholesterol and lowering triglyceride levels), and reduce the risk of cardiovascular death and nephroprotection. Ipragliflozin, a new representative of the class of sodium glucose cotransporter-2 inhibitors, registered in Russia, has shown effectiveness in relation to glycemic control, reducing the levels of glycated hemoglobin and fasting plasma glucose both in monotherapy and in combination with other antihyperglycemic drugs. The PRIME-V and ILLUMINATE studies have demonstrated that ipragliflozin helps to reduce insulin resistance, body weight, BMI and waist circumference, total and LDL cholesterol. Positive effects of ipragliflozin on pancreatic β-cell mass and function have been shown in animal studies. Several studies have examined the beneficial effects of ipragliflozin on the course of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus. Significant reductions in ALT and GGT levels and a decrease in the absolute percentage of liver fat have been shown. Animal studies have confirmed the effect of ipragliflozin on the histological characteristics of NASH. The review presents data on the efficacy of ipragliflozin in relation to the components of the metabolic syndrome in patients with type 2 diabetes mellitus, and also discusses the likely mechanisms of a positive effect of the drug on the course of NASH in type 2 diabetes mellitus.